On my 4th Trays and Can Not Get the Top Aligner On. Dentist is Now Closed for W/E?

While one of the most exciting breakthroughs in dentistry for correcting functional and aesthetic problems related to dental malocclusion with a rather "benign" removable clear aligner system, Invisalign also has its share of "adjustment problems" for patients who choose to take advantage of the benefits this treatment has to offer. After hundreds of visits and experiences with patients who are under my care for Invisalign, including a few who have "aborted" treatment in frustration with the management of their aligner trays, I have put together my Top Ten Tips for helping patients get to the Invisalign Finish Line without getting hung up on the process. (Note: first five are tips for inserting aligners, and the second five tips are for easier removal.) 

1. Stand in front of the mirror and practice. Each aligner is designed to move your teeth a small amount according to an overall plan which your dentist should have reviewed with you. As a result, most aligners feel tight and may be difficult to insert initially. It makes it easier for you to visualize if you practice in front of a mirror and observe the easiest "path of insertion."

2. Try inserting trays over the anterior (front) teeth first. Depending on how many bonded attachments are placed, putting the tray over the front teeth first and then the back teeth seems to be the easiest for most patients.

3. Put the tray under warm water to make them more maleable. Do not use hot water as this can permanently deform the tray. However warm water does soften the tray slightly and make it easier to get over the attachments. 

4. Use a lubricant on attachments. A small amount of a lubricant such as vaseline on odd shaped or placed attachments can reduce friction and assist with the initial insertion of an aligner tray.

5. Change to a new aligner before bed. Putting a new aligner in before you sleep allows some time for the teeth to move and avoid removing the aligner before meals which can be more difficult during the day.

6. Remove your aligners in the opposite direction from which they were inserted. This generally means removing an aligner from the back first.

7. Use a (safe) removal instrument if necessary. There are several tools available including a polished end tweezer that can be effective for removal and keep you from destroying a good manicure. One I prefer is called the "Outie" a plastic instrument that is available on amazon.com.

8. Dry the aligner and your fingers with a napkin, paper towel or tissue before removal. To get a better grip to remove an aligner tray, try drying the tray first and be sure your fingers and hands are dry as well.

9. Do not try to remove your aligner after a cold drink. This may be simple sense but cold can make the trays stiffer and harder to remove.

10. Relax, be patient, and do not force anything. Panic is the enemy of Invisalign insertion and removal. Trying to force a tray can actually cause a "crimp" of the tray margin, and pulling a tray out with too much force can cause a tray to tear rendering the tray ineffective.

Have you tried seating the front teeth first, then the back teeth? Or try the left or right side first, then the middle teeth, then the other side... or reverse it. And finally try seating the left or right side first, then the other side, then the  front teeth. Hopefully you will find the right combination.  Have you tired to use an erraser  and gently bite down on the area that is not seated?